Early Changes in Adipose Tissue Morphology, Gene Expression, and Metabolism After RYGB in Patients With Obesity and T2D

Katsogiannos, Petros; Kamble, Prasad G.; Boersma, Gretha J.; Karlsson, F. Anders; Lundkvist, Per; Sundbom, Magnus; Pereira, Maria J.; Eriksson, Jan W.

doi:10.1210/jc.2018-02165

Cited by 28 publications

(54 citation statements)

References 34 publications

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“…The downregulation of inflammatory genes in SAT after weight loss that we observed in our cohort of adolescent girls is in accordance with the observation of other groups that showed a reduction in inflammatory markers, such as CD68 and MCP1, after surgery or after caloric restriction (65,(69)(70)(71). In contrast, others described a reduction or even no significant changes in IL6, TNF, or IL18 after weight loss (72,73).…”

Section: All Follow-up Patients (N = 9)supporting

confidence: 92%

The omentum of obese girls harbors small adipocytes and browning transcripts

Tarabra¹,

Nouws²,

Vash‐Margita³

et al. 2020

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Section: All Follow-up Patients (N = 9)supporting

confidence: 92%

The omentum of obese girls harbors small adipocytes and browning transcripts

Tarabra¹,

Nouws²,

Vash‐Margita³

et al. 2020

JCI Insight

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“…However, our ndings are in agreement with a previous study that reported increased adiponectin expression after 6M (51). Given that in ammatory pathways can exert opposing or redundant functions, the decreased expression of genes encoding adipokines at adipose tissue, may be responsible for the improved metabolic and decreased insulin resistance seen at RYGB.…”

Section: Discussionsupporting

confidence: 93%

Bariatric surgery can acutely modulate ER-stress and inflammation on subcutaneous adipose tissue in non-diabetic patients with obesity

Ferraz-Bannitz

Welendorf

Coelho

et al. 2020

Preprint

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Background Bariatric surgery, especially Roux-en-Y gastric bypass (RYGB) is the most effective and durable treatment option for population with severe obesity. The mechanisms involving adipose tissue may be important to explain the effects of surgery. Methods We aimed to identify the genetic signatures of adipose tissue in patients undergoing RYGB. We evaluated 13 obese, non-diabetic patients (mean age 37 years, 100% women, Body mass index (BMI) 42.2 kg/m2) one day before surgery, 3 and 6 months (M) after RYGB. Results Analysis of gene expression in adipose tissue collected at surgery compared with samples collected at 3M and 6M Post-RYGB showed that interleukins (Interleukin 6, Tumor necrosis factor-α (TNF-α), and Monocyte chemoattractant protein-1(MCP1)) and endoplasmic reticulum stress (ERS) genes (Eukaryotic translation initiation factor 2 alpha kinase 3 (EIF2AK3) and Calreticulin (CALR)) decreased during the follow-up (P ≤ 0.01 for all). Otherwise, genes involved in energy homeostasis (Adiponectin and AMP-activated protein kinase (AMPK)), cellular response to oxidative stress (Sirtuin 1, Sirtuin 3, and Nuclear factor erythroid 2-related factor 2 (NRF2)), mitochondrial biogenesis (Peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC1α)) and amino acids metabolism (General control nonderepressible 2 (GCN2)) increased from baseline to all other time points evaluated (P ≤ 0.01 for all). Also, expression of Peroxisome proliferator activated receptor gamma (PPARϒ) (adipogenesis regulation) was significantly decreased after RYGB (P < 0.05) We also observed a strong positive correlation between PGC1α, SIRT1 and AMPK with BMI at 3M (P ≤ 0.01 for all) and ADIPOQ and SIRT1 with BMI at 6M (P ≤ 0.01 for all). Conclusions Our findings demonstrate that weight loss is associated with amelioration of inflammation and ERS and increased protection against oxidative stress in adipose tissue. These observations are strongly correlated with a decrease in BMI and essential genes that control cellular energy homeostasis, suggesting an adaptive process on a gene expression level during the caloric restriction and weight loss period after RYGB.

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“…Our cohort consists of obese patients with type 2 diabetes, randomized 2:1 to RYGB or conventional diabetes treatment. In a first report, we showed that insulin action in adipocytes was not improved after 4 weeks, despite markedly reduced cell size, and could not explain the short-term improvement of whole-body insulin sensitivity [10]. Here we report rapid changes in hormonal and autonomic nerve regulation which can contribute to the antidiabetic effects of RYGB.…”

Section: Introductionmentioning

confidence: 63%

“…Beneficial metabolic effects in RYGB patients, including weight loss and improved glycemic control and insulin sensitivity, were recently published [10]. In summary, the patients undergoing surgery showed significant reductions after 4 and 24 weeks in BMI, fasting insulin levels, and HbA1c with the reductions being more pronounced after 24 weeks.…”

Section: Resultsmentioning

confidence: 91%

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Rapid changes in neuroendocrine regulation may contribute to reversal of type 2 diabetes after gastric bypass surgery

et al. 2020

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Objective To explore the role of hormones and the autonomic nervous system in the rapid remission of diabetes after Rouxen-Y Gastric Bypass (RYGB). Research design and methods Nineteen obese patients with type 2 diabetes, 7 M/12 F, were randomized (2:1) to RYGB or standard-of-care medical treatment (control). At baseline and 4 and 24 weeks post surgery, fasting blood sampling, OGTT, intravenous arginine challenge, and heart-rate variability (HRV) assessments were performed. Results At both 4 and 24 weeks post-RYGB the following effects were found: arginine-stimulated insulin secretion was reduced. GLP-1, GIP, and glucagon rise during OGTT was enhanced. IGF-1 and GH levels increased. In addition, total HRV and spectral components P LF (power of low frequency) and P HF (power of high frequency) increased. At 4 weeks, morning cortisol was lower than baseline and 24 weeks. At 24 weeks, NEFA levels during OGTT, and the P LF /P HF ratio decreased. None of these changes were seen in the control group. Conclusions There were rapid changes within 4 weeks after RYGB: signs of enhanced parasympathetic nerve activity, reduced morning cortisol, and enhanced incretin and glucagon responses to glucose. The findings suggest that neurohormonal mechanisms can contribute to the rapid improvement of insulin resistance and glycemia following RYGB in type 2 diabetes.

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Early Changes in Adipose Tissue Morphology, Gene Expression, and Metabolism After RYGB in Patients With Obesity and T2D

Cited by 28 publications

References 34 publications

The omentum of obese girls harbors small adipocytes and browning transcripts

The omentum of obese girls harbors small adipocytes and browning transcripts

Bariatric surgery can acutely modulate ER-stress and inflammation on subcutaneous adipose tissue in non-diabetic patients with obesity

Rapid changes in neuroendocrine regulation may contribute to reversal of type 2 diabetes after gastric bypass surgery

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